This document provides guidance on vector control methods for preventing and controlling dengue, specifically focusing on controlling the Aedes mosquito that spreads the dengue virus. It discusses that dengue is transmitted via the bite of an Aedes mosquito carrying the virus. To prevent transmission, it is important to control the Aedes mosquito population by eliminating breeding sites and applying larvicides. The document outlines the life cycle of the Aedes mosquito and provides specific guidance on integrated vector management, including environmental management to remove stagnant water, biological controls using Bti or fish, and chemical controls applying larvicides like temephos. It emphasizes the importance of larval source reduction and larval control over indoor spraying since Aedes
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Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
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IMPACTION
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DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
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FLATULENCE
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FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
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WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
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PPT 3 English GTA modified.pptx
1. Vector control method for
Dengue prevention and control
Department of Health & Family Welfare,
Govt. of West Bengal
2. Dengue is a virus caused disease
This disease spreads by the mosquito Aedes mosquito.
When mosquitoes bite a dengue infected person, virus enters into the
mosquito’s body. Then the number of viruses in the mosquito increases.
When this mosquito bites a healthy man, the dengue virus passes away to
the human body and the person becomes infected with Dengue virus.
Dengue may be lethal.
This disease occurs throughout the whole year but increases in the rainy
season.
Therefore, to prevent this disease, Dengue mosquitoes
i.e. Aedes mosquitoes are needed to be controlled.
Dengue……
3. Common Mosquito vectors (Four Winged Enemies )
ANOPHELES
MALARIA
CULEX
FILARIA,
JAPANESE ENCEPHALITIS
5. Dengue Fever – Mode of Transmission
Infected
mosquito
Healthy person Infected person
Dengue fever is not spread by contact with
infected persons.
To control the disease, control the vector.
Intrinsic Incubation
Period: 3 to 14 days.
Commonly 4 to 7 days
Extrinsic
Incubation Period:
8 to 10 days.
6. Eggs are hatched
within 48 hours
Adult
mosquito
feeds on
blood for
the
development
of the eggs
Life Cycle of Aedes Mosquito
Adult are very active and resistant to most insecticides. So, to
control mosquito, control of larvae is the smart choice.
The larvae
develop to pupae
within
7days
The newly emerged adult
mosquito rests on the
surface of the water for a
short time to dry and allow
all its parts to harden.
Adult mosquito
lives for 1-2 months
The pupae
develops to
adult within 1- 4
days
7. Some Facts About Aedes Mosquito
Also known as Tiger Mosquito for their silvery white
stripes and bands on black background.
Blackish form of mosquito.
can infect more than five person -Multiple feeder-
Day biter (mainly)
Eggs can carry the diseased organism- Trans- ovarian: The disease organism
is transmitted to eggs through ovary of infected female
- 752 eggs in 72 days
- 140 eggs in one laying (Hence breeding sources should be destroyed)
Found in the clean water, in cool shady places – the larval stage.
8. How to control Aedes Mosquito
1) Adult Mosquito Control
2) Larval Mosquito Control
3) Prevention of connection between human and mosquito.
(Use mosquito net both in day and at night. Dengue patient should always
stay inside the mosquito net so that no mosquito can bite her/him.)
Always remember, Adult mosquito flies and can escape easily that is why
adult mosquito control by chemical method i.e. fogging.
Larva can not fly and always remain in water. That’s why, Larva control is
the best method.
9. Vector control activities
• Spray worker are not aware of what they are spraying,
neither they maintain the dosage.
• In most of the places “Temephos” is the only insecticide in
their list.
• Spray workers are not sensitised where to spray.
• Source reduction in not in practise in most of the places.
• Clogged drain, garbage pile removal is not done on regular
basis.
• Such practises, cleaning & spraying should be done in the
domestic places (if required), also.
• Release of fish is a new trend, which is very encouraging, but
if we do not follow the guideline, it will be very less effective.
10. How to control Aedes Mosquito
Aedes mosquitoes mainly bite in daytime. Then hide and take rest in dark
places, behind furnitures or clothes etc. They don’t rest on the wall.
So……
They can not be controlled by outdoor fogging.
They even can not be controlled by Indoor Residual Spray (IRS-DDT).
Though Indoor Space Spray is effective, but in real fact, it is not
possible by spraying house to house in a large area. It can be applied in
own house or office.
So We have to give attention in Larval Control for Aedes Mosquito Control
11. Larval Mosquito Control …. 1/2
1. Environmental management- Destruction of Mosquito breeding sources.
2. Biological Control – Control by Bti (Bacterial toxin), Fishes which take
mosquito larva as their food like Guppy, Lata, Gambusia, Tilapia etc.
3. Chemical Control – Control by oil or Larvicide.
12. Larval Mosquito Control …. 2/2
Environmental management- Destruction of Mosquito breeding sources.
1. Don’t keep clay or plastic containers or garbage here and there.
Clean the garbage immediately.
2. Cover the water storage containers, tank etc.
3. Clear the clogged drain.
4. If there is any low areas filled with water, release it. Fill the areas
with clay/ sand.
13. Where can mosquito larvae be controlled?
In the house. Around the house.
The streets in the middle of the
house.
Some places that are easily
overlooked.
The place where the garbage is
disposed.
In the market.
In construction sites.
Some places such as bus stand,
school, station, etc. where lots of
people used to gather.
• Where to find mosquito breeding places?
14. How to search for breeding sites in
domestic areas
Cover the containers or use the water within 7 days.
Spray may not be required in such places
17. Combined efforts of different departments
In addition to destroying containers where mosquitoes can lay eggs in the
house, following measures should be taken for mosquito control:
Garbage should be cleaned regularly.
Drainage system should be clear.
Arrangement of filling up lower grounds where water is stored.
Therefore, vector control should be done by coordination or cooperation
among various departments of the municipality.
18. Each vector control team should have 6workers. 6 workers: - At least 2 trained spray workers
and the rest are ordinary workers. The team has two sprayer (knapsack sprayer).
Vector Control team will work for 5 days weekly.
The Vector Control Team will look around everywhere in the ward - roads, markets, factories,
grounds, open spaces, and inside and outside the house premises. In the areas where the larvae is
found, the HTH team will mention Form 3, where appropriate action will be taken within one day.
Then fill up the right side and sign the form and submit to the SI.
Vector Control Team
19. From the SI or from the municipal control room, the location of some vulnerable place in
the environment will be informed to the vector control team. Such as: “Pile of Garbage,
unprotected construction site, business of tyre repair / waste materials, blocked drain" -
places to be managed as well.
The Vector Control Team will fill up the form 10 every day with the information
that will be done and submit it to SI. The councilor has to sign the form before
submitting.
Vector Control Monitoring Team will monitor-
• Whether larvicide is mixed with the right amount with water.
• Whether it is spraying in the right place; Not in the bush / wall / dry place.
• On the other hand, whether the spray is done where the spray is needed.
Only use the larvicide mentioned on the NVBDCP website (www.nvbdcp.gov.in).
Vector Control Team
20. Chemical Method:
1) Make a list of Environmenal Risk Sites, where the water is
stagnant and mosquitoes can lay eggs.
2) Geographical mapping of environmental risk areas.
3) Determine which larvicide should be used.
4) Know the amount of larvicide and how often it should be
used.
5) Supervisor and SI have to supervise the work of this spray
regularly.
21. Pour 5 ml to 7.5 ml into a small glass or plastic container.
It can be measured at 10 ml measuring cylinder or 5ml injection
syringe.
(In such way five-ten containers of larvicide can be measured.)
Now take 10-liter clean water in the knapasack sprayer tank and
mix 5- 7.5 ml temephos with it.
Turn off the tank and shake well.
Approximately 20ml mixture can be sprayed in every square meter
water.
It will be sprayed again every 7 days.
Temephos 50% EC. Also known as ABATE
How to make mixture of Temephos or ABATE.
22. What equipment to use:
Remember - tempehos do not work on the adult mosquito. So do not waste
by spraying in the dry place on the plains, walls, the bush.
Map and Cans method for Temephos spray is not
recommended.
Only with hand compression or knapsack sprayer, Temephos
should be sprayed.
The discharge rate of spray machine should be 740- 850ml /
min.
Where the water is not going out, it will be sprayed again
every 7 days
23. Bacillus thuringiensis israelensis (BTI) – WP or 12 AS
BTI is a chemical that is fed by mosquito larvae, poisons its body and causes the
larvae to die.
BTI (WP)
BTI 2.5% wp is soluble in water.
250 gm (strain 164)/375 gm (ABIL)of this powder are mixed in 10 liters of water.
First, make a paste the powder in a small water. Then make a mixture with the
remaining water in the bucket.
This mixture can be sprayed in an interval of 2 weeks(Starin 164) or one week
(ABIL).
BTI 12AS
It is available as a liquid substance.
To spray in clean water, mix 50 ml of chemical in 10 liters of water and to spray in
dirty or contaminated water, add 100 ml of chemical to 10 liters of water.
Spray with the knapsack or hand compression pump.
Bt 12 AS Spraying is needed in interval of 7 days.
24. What to spray as insect growth regulator?
Diflubenzuron 25% WP - to stop the development of mosquitoes.
This chemical stops the growth of mosquitoes; So mosquito larva does not
reach the adult stage.
The method of mixing this chemical:
This chemical is available as 500 g bag in the market.
100 grams of powder is mixed in 100 liters of water, or 10 grams of powder is
mixed in 10 liters of water.
First make a thick paste, then mix the remaining water and make the mixture.
25. Do's and Don'ts:
Do’s :
• Destroy the pot or mosquito breeding
place where it can be destroyed.
• Use knapsack during the spray time.
• Mix larvicide in a specified amount.
• Spray at least one week a week or follow
the rules as mentioned.
• If the larvicide is not available, then
apply at least Kerosene oil or burnt
Mobil.
• Spray wherever needed inside the house
and on the street.
• The area that is beyond of your control
should be informed to your Higher
Authority.
Don’ts:
• Inadequate larvicide mixing.
• Spraying where the pot is destroyed
can be controlled.
• Standing in a high place or spraying
far away, which does not reach the
right place.
• Spray in dry place.
• Forget to spray again the place where
spray has been done once.
Spray workers, HTH team staff
And it is important to keep
contact among the supervisors
26. What to spray to kill the larvae? (NVBDCP Guideline)
27. Thermal fogging.....1/4
Aedes mosquito takes shelter under the furniture / clothes, curtains or hanging
materials.
So Fogging's usefulness in the control of the adult mosquito is very little. That's why
thermal fogging is not usually recommended.
Although in some cases thermal fogging is to be used.
Fogging should be done by cyphenothrin or technical malathion (not other
formulations).
28. Where should fogging done?
The fog should be on the opposite side of the air.
Fogging shuld be done in places where the adult mosquitoes lay eggs or rest,
such as the sewage / pondakur / submerged water.
Run the hand by two and a half to three meters before the fogging machine after
keeping it on to see whether feeling wet.
The technical specification recommended for fogging machine should be of
BIS standard no. 14855 (Part 1): 2000 for Vector Control
29. When should be fogging done?
The right time to fog is just before the afternoon and evening
Or in the morning.
Fogging is not benficial if there is too much wind or storm or rain.
During fogging, the windows of the adjacent house of the street should be opened.It
is better to keep doors and windows off of distant homes
Thermal fogging.....2/4
30. Thermal fogging.....(3/4)
• Time of fogging for dengue/ chikungunya : early morning to early
evening.
Climatic
condition
Most favourable
conditions
Average
conditions
Unfavourable
condition
Wind Steady, between
3-13 km/hr
0-3 km/hr Medium to strong,
over 13 km/hr
Rain No rain No rain Heavy rain
Temperature Mild Mild Hot
• An optimum wind speed of between 3 and 13 km/hr enables the spray to
move slowly and steadily over the ground, allowing for maximum exposure of
mosquitoes to the spray.
• In heavy rain, the spray generated loses its consistency and effectiveness.
31. Guideline for release of fishes
• Should be small in size to survive in shallow water.
• Should be surface feeders and carnivorous.
• Should be able to survive in the absence of mosquito larvae.
• Should be easy to rear.
• Should be able to withstand a wide range of temperature and light intensity.
• Should be hardy and able to withstand transport and handling.
• Should be insignificant/useless as food for other predators.
• Should have preference for mosquito larvae over other types of food available at the water
surface
• Fishes move in herds, hence presence of dense vegetation will inhibit their movement.
• In the clogged drain (without cleaning) fishes will get trapped in shallow pockets and the rest of
the area of the drain will remain unaffected, facilitating mosquito breeding
32. Guideline for release of fishes
• Measure the perimeter of water body.
• Release the fishes at the rate of 5-10 fish per linear meter.
• If the larval density is high more fish up to 20 can be released.
• E.g Gambusia, Poecilia, Panchax
Precautions during release of fish
• Fishes should be released in the morning hours or in the evening.
• Before releasing ensure that the temperature of water both in
container and in the larval habitat is more or less same.
• Clean out dense vegetation from the water body.
• Ensure that water body is free from predators of larvivorous
fishes.
34. NVBDCP-approved insecticides
Insecticide Commercial formulation Remarks
(A) Indoor space spray
Cyphenothrin 5% EC 20 ml in 1 ltr k.oil
Pyrethrum extract 2% extract 1:19 (50 ml in 1 ltr k.oil)
(B) Outdoor (thermal) fogging
Malathion Technical malathion 1:19 (50 ml in 1 ltr diesel)
Cyphenothrin 5% EC 7 ml in 1 ltr diesel
(C) Larvicides : 6 (six) such as shown in Slide No. 21
(D) Indoor Residual Spray: Not shown here as scope is limited in urban areas
35. CIB-approved sources of active ingredients
Sl.
No. Common Name
IUPAC name
(Serial
number in
Schedule)
Approved Source for Import
(M/s)
Indigenous manufacturers (M/s)
----- -- --- ----
7 Alpha-cypermethrin
Technical
95% min.
Long Lasting Nets
Impregnated with
Alphacypermethrin
0.667% w/w for import*
416 1. Cynamid Quimica do Brasil
Ltd., Resendez, Brazil
2. *M/s Sunshine World Net
2003 Co. Ltd., 18/2 Moo 7,
Rattanatibet Road, Bangkrasor
Muang Nonthaburi, 11000,
Thialand.
1. BASF India Ltd., Mumbai
2. Gharda Chemicals Ltd., Mumbai.
3. Coromandel International Ltd.,
Secundrabad
4. Rotam India Limited, Mumbai
------- -------
36 Basillus Species
Thruingiensis Berliner var.
Kurustaki Serotypes 3a, 3b,
SA II WG
326 1. Cetris, USA LLC
2. Thermo Triology Corporation,
USA
Margo Biocontrols Pvt. Ltd.
74 Cyfluthrin Technical
90% min,
415 1. Bayer Crop
Science AG,
Germany
2. Mitchell
Cotts
Chemicals,
UK
75 Cyphenothrin Technical
92% min. and 7.2%VP
417 1. Sumitomo Chemicals, Osaka,
Japan.
2. Earth Chemicals Co. Ltd., New
Awajmachi Bldg., 3-14, 1-
chome, Chuo-Ku, Osaka, Japan
---
36. CIB-approved sources of active ingredients….2/2
278 Temephos
Technical
90% min.
201 American Cynamid
Co., USA
1. Gharda Chemical,
Mumbai
2. Cynamid India,
Mumbai
3. Hikal Ltd
4. Bharat Rasayan Ltd,
New Delhi.
5. United Phosphorus
Ltd., Mumbai
6. Coromandel
International Ltd.
306 ----- -- --- ----
Source: Website of Central Insecticide Board & Registration Committee,
Govt. of India (www.cibrc.nic.in)
NB: An abridged version of CIB-approved list will be given with the guideline
37. Documents required……1/2
Product = commercial formulation as procured from suppliers.
• Product :
- Should be having NVBDCP and TAC approval.
- Must be registered with CIB (copy of CIB registration
certificate to be submitted along with the offer).
- Valid Manufacturing License to be submitted for the
particular product.
• Shelf life of the product must be 2 years from the date of
manufacturing.
• Source:
- ‘CIB approved source of Import’- certificate / valid
agreement & bill/invoice of purchase from the approved
source to be submitted (if not proprietary products).
38. Documents required……2/2
• In case of proprietary insecticides, proprietary certificate from the manufacturer
to be submitted.
• Test report and guarantee certificate from the manufacturer to be submitted at
the time of supply.
• Either manufacturer or their authorised distributors are eligible to participate
with tender-specific valid authorization certificate from the manufacturer along
with the offer.